| NPI | 1477692838 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 357)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 16309)  | 
| Enumeration Date | 2007-02-05 | 
| Last Update Date | 2011-11-30 |